You do not say how old your son is, but a hb of 5 is uncomfortably low in any patient let alone one undergoing chemotherapy for leukemia. Nevertheless there are numerous reported cases of EPO being used successfully to treat hbs much lower than that.

For instance, the article "Introduction of Erythropoietin in the Treatment of Acute Lymphoblastic Leukemia (ALL) in a Patient of Jehovah’s Witnesses Persuasion: A Case Report", in the Medical and Pediatric Oncology Supplement 2:23–25 (1992), reported the case of a 4-year-old boy undergoing treatment for ALL. At one point during his treatment his hb fell to 4 g/dl, yet at no time was blood transfusion given. The authors concluded:

"As a result of the daily injections of EPO, the patient could be given high intensity chemotherapy without blood transfusions. During this part of the treatment for ALL in childhood, patients usually need the transfusion of 2 to 4 units of red blood cells, even when starting with a higher hemoglobin level. Under the treatment with arabinocytosine (ARA-C) even high serum levels of EPO were not able to stimulate erythropoiesis further. The drug ARA-C is known to affect the stem cell proliferation, and therefore may interfere with the stimulation of erythropoietic progenitors by EPO. The same problem may arise during supportive treatment with other cytokines. The combined application of different growth factors, in the case the combination with I1-3, may suspend this inhibition and improve supportive treatment of malignant disease further."

Much will come down to the willingness of the particular doctor to cooperate. Interestingly, the article "Management of severe anemia without transfusion in a pediatric Jehovah’s Witness patient", in Critical Care Medicine 1994 Vol. 22, No. 3, in disscusing the treatment of a 12-year-old Jehovah's Witness patient, made the following observation:

"The therapy adopted in this case is cumbersome, expensive, and potentially hazardous to the patient. However, we felt obliged to respect the religious views of our patient and his family. Our patient is a minor and, therefore, he qualifies for court-ordered transfusion, which would have been granted if child endangerment was pleaded in court. Such a step would have strained the relationship between the patient, his family, and the medical staff. Also, a case of child endangerment or negligence would have been difficult to justify in this situation, given the fact that both parents had each donated a kidney to their child at different times during his illness. Jonsen (27) advocated a non-paternalistic ethical viewpoint when dealing with Jehovah’s Witnesses. This view expects physicians to respect the wishes of a patient competent to make decisions about his/her own health. The patient described herein is a very articulate 12-yr-old who is well liked by the medical staff. He was treated as an emancipated minor in this case because of the prior contractual agreement between the patient, parents, and transplant team that he would not be given blood transfusion against his wishes, and because of the need to preserve a delicate physician/patient relationship fostered over the years of caring for him."

Incidentally, at one point, this patient's hb dropped to 2.1, yet still no blood transfusion was administered. Perhaps your son's doctor could consider these points, or if he/she feels unable or is unwilling to treat your son without recourse to further unwanted blood transfusions, your son's care could be transferred to another, more cooperative physician?

Hello again, thanks for information, I will print it out and present it to our doctor and see what he says...

By the way our son is 16yrs old and is very, very angry and depressed because the doctors dont listen to him. He has withdrawn into himself and is barely approachable by anyone!

The Prof. over the Childrens hospital claims that EPO increases also the growth of the "bad" white blood cells, that is why his clinic does not use it! Have you heard anything about that?

There is another hospital that also works with us really well but they are 4 hours away from where we live and the main part of the treatment would take at least 6-9months... I would love to go there but I have 2 other younger children and no family here (they all live in the States),and financially I dont think its possible either! I feel so fustrated and helpless, the doctors here are put on the same level as a God, they cant make no mistake and they are Invinsable!!